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August 28, 2008

Medical Choices for the Twenty First Century

During the Twentieth Century, sweeping changes overtook American Medicine; its knowledge base was greatly expanded, how it is taught and practiced changed radically; ditto, how care is delivered and paid  for. Also, especially since the passage of Medicare, Medicine is having an increasing influence on both the nation’s demographics and its economy.

Among the more affected disciplines have been Psychiatry and Psychology, particularly as related to the classification of mental conditions and with respect to drugs, whether therapeutic or illegal. Nevertheless, our drug policy’s concepts regarding addiction, the need for abstinence, its reliance on harsh criminal penalties, and its corresponding lack of interest in clinical details remain firmly rooted in 1910 and the the possibility of a policy formulation being mistaken is never considered.

Also, despite its blatant record of failure, the disgraceful changes in our prison system, the widely acknowledged lack of drug treatment for prisoners, the beliefs underpinning America’s drug war have not been questioned or even seriously criticized by Medical Academia. Instead, the drug czar and NIDA are able to claim their policy is both rational and succeeding.

The international silence with which drug war failures are greeted had also told me that other governments lack a realistic drug policy, but I was unprepared for the profound denial that would greet a cautiously worded clinical study raising questions about pot use, or that I’d be scolded by reform veterans for “medicalizing recreational use.”

 I now see the intensity with which bias may be exerted to protect such an obviously bad policy as our species' most dangerous cognitive flaw. Unless we can learn to minimize our innate dishonesty, I fear for our future. Given our relatively short life expectancy, a substantial move towards a sustainable level of population in a less competitive setting might just be possible, but the hour is late, and continued dithering in pursuit of cheaper gasoline is clearly unacceptable. 

Doctor Tom

Posted by tjeffo at August 28, 2008 08:12 PM